目的：探讨经阴道超声三维宫腔成像在评估宫腔粘连患者宫腔内环境中的作用。方法：2014年11月至2016年6月在南京鼓楼医院妇科就诊的拟诊宫腔粘连患者，在治疗前后每次行宫腔镜检查前常规进行经阴道超声检查，通过实时三维成像技术获取宫腔冠状切面成像，测量宫腔大小，评价宫腔形态，了解宫腔粘连程度。结果：共纳入134例患者，均在治疗前后的宫腔镜检查前行经阴道超声三维实时宫腔成像，结果发现，三维实时宫腔成像在评价宫腔形态、观察宫角能否显示、测量宫腔深度等方面与宫腔镜检结果基本一致，诊断符合率超过90%，且三维成像及后处理技术可以测量宫底部宽度和宫腔容积，更加量化宫腔内环境。但超声在瘢痕面积占比的评估方面不如宫腔镜检查直观。结论：经阴道超声三维实时宫腔成像可以较准确地评估宫腔形态，可以作为宫腔粘连患者筛选及治疗前后反复对照、评价疗效的首选检查。

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